Provider Demographics
NPI:1730707282
Name:MOLINA-SCHMUKER, ADRIANA (LLMSW)
Entity type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:MOLINA-SCHMUKER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15386 BAYOU MEADOWS ST
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-2836
Mailing Address - Country:US
Mailing Address - Phone:616-970-2032
Mailing Address - Fax:
Practice Address - Street 1:901 EASTERN AVENUE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503
Practice Address - Country:US
Practice Address - Phone:616-307-7594
Practice Address - Fax:616-827-0762
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801104216101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health